Lung Cancer Surgery Can Be Beneficial for High-Risk Patients with Early Stage Disease

A multidisciplinary approach is necessary to determine best treatment for each patient

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Chicago, 10 November 2015

Surgical
lung resection, in which part of a lung is removed, can be a safe and effective
treatment option for high-risk patients with early stage lung cancer, according
to an article posted online by The
Annals of Thoracic Surgery.

Key Points:

Surgical lung resection can safely be used as a treatment option with good results for patients with lung cancer who have been identified as high-risk for surgery.

Overall length of hospital stay was longer for high-risk patients compared to standard-risk patients, but there was no difference among the two groups in post-operative mortality.

The researchers emphasize the importance of a multidisciplinary approach to determine the best treatment plan for each individual lung cancer patient.

Previous research
has shown that most patients with lung cancer who undergo pulmonary resection
are age 60 years or older, have a significant smoking history, and have numerous
other conditions—such as lung disease or heart disease—that could lead to
higher rates of complications or death following lung surgery.

“Consequently, one
in five patients with stage I non–small-cell lung cancer is deemed inoperable
or at high-risk for surgery,” said Manu S. Sancheti, MD, from Emory University
in Atlanta. “Our research shows these patients should not be denied surgery,
because they may benefit from it.”

Dr. Sancheti led a
research team that identified 490 patients who underwent surgical resection for
early stage lung cancer at Emory from 2009 through 2013. Patients were
classified as standard risk (310 patients) or high risk (180 patients), based
on previously published criteria from the American College of Surgery Oncology
Group.

The researchers
evaluated patient outcomes and survival following surgery and found that
overall length of hospital stay was longer for high-risk patients (5 days)
compared to standard-risk patients (4 days), but there was no difference among
the two groups in post-operative mortality (2% for high-risk patients; 1% for
standard-risk patients).

“Importantly, we
found that about 20% of our patients had cancer that had spread to their lymph
nodes, a finding that was unexpected based on the pre-operative imaging tests,”
said Dr. Sancheti. “This group of patients was able to undergo chemotherapy,
which is an important adjunct treatment for their cancer stage. This spread of
cancer to the lymph nodes would not have been discovered and accordingly
treated through a non-surgical approach.”

At 3-years
post-surgery, the researchers found that 59% of high-risk patients were still
alive, and 76% of standard-risk patients had survived.

“Our results show
that surgical resection is an acceptable treatment option with good results for
patients with early stage lung cancer who have been identified as high-risk for
surgery,” said Dr. Sancheti. “High-risk patients have a new treatment avenue
that previously may have been denied to them. A multidisciplinary team should
review each case to determine the best treatment plan for individual lung
cancer patients.”

Full text of the article is
available to credentialed journalists upon request; contact Cassie McNulty cmcnulty@sts.org at +1 312 202 5865.

About The Annals of Thoracic
Surgery The Annals of Thoracic Surgery is the official journal of STS and the Southern Thoracic Surgical
Association. Founded in 1964, The Society of Thoracic Surgeons is a
not-for-profit organization representing more than 6,800 cardiothoracic
surgeons, researchers, and allied health care professionals worldwide who are
dedicated to ensuring the best possible outcomes for surgeries of the heart,
lung, and esophagus, as well as other surgical procedures within the chest. The
Society’s mission is to enhance the ability of cardiothoracic surgeons to
provide the highest quality patient care through education, research, and
advocacy.

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